Saving Single-rooted Teeth with Combined Endodontic-periodontal Lesions

Abstract

IntroductionTeeth affected by combined endodontic-periodontal lesions are usually considered by all prognosis classifications as hopeless teeth. The development of new biomaterials combined with modern endodontic and periodontal regeneration techniques may improve dental prognosis and maintain the affected teeth. Moreover, 1 of the replacement options for those teeth, dental implants, has shown an increasing number of biological and technical complications. MethodsFive patients were included in this case series study. Full periodontal and radiographic examination revealed generalized chronic periodontitis. Moreover, endodontic-periodontal lesions affecting single-rooted teeth were detected in those patients with tissue destruction beyond the apex. After splinting those teeth, conventional endodontic and nonsurgical periodontal treatment was performed. Three months later, periodontal regeneration was applied at those teeth in order to reconstruct supporting tissues and to improve dental prognosis. ResultsAfter a follow-up period ranging from 14 months to 17 years, it was observed that all teeth remain asymptomatic and in normal function. No signs of apical pathosis were observed, and the periodontium was stable. All patients were included in a strict maintenance program to check the periodontal and apical status. ConclusionsThis case series shows that it is possible to change the prognosis of teeth affected by combined endodontic-periodontal lesions, even if the periodontal support is destroyed beyond the apex.